Mortality prediction in chronic obstructive pulmonary disease comparing the GOLD 2015 and GOLD 2019 staging : a pooled analysis of individual patient data
García Castillo, Elena (Hospital Universitario de la Princesa (Madrid))
Alonso Pérez, Tamara (Hospital Universitario de la Princesa (Madrid))
Ancochea, Julio (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Pastor Sanz, Maria Teresa (Instituto de Investigación Hospital Universitario de la Princesa)
Almagro, Pere (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Martínez-Camblor, Pablo (Geisel School of Medicine at Dartmouth)
Miravitlles, Marc (Hospital Universitari Vall d'Hebron. Institut de Recerca)
Rodríguez-Carballeira, Mónica (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Navarro, Annie (Hospital Universitari MútuaTerrassa (Terrassa, Catalunya))
Lamprecht, Bernd (Kepler-University-Hospital)
Ramírez-García Luna, Ana S. (Universidad Autónoma de San Luis Potosí (Mèxic))
Kaiser, Bernhard (Paracelsus Medical University Hospital)
Alfageme, Inmaculada (Universidad de Sevilla)
Casanova, Ciro (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Esteban, Cristóbal (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Soler-Cataluña, Juan J. (Hospital Arnau de Vilanova (València))
De Torres, Juan Pablo (Queen's University)
Celli, Bartolomé R. (Brigham and Women's Hospital (Boston, Estats Units d'Amèrica))
Marín, Jose M. (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
ter Riet, Gerben (Amsterdam UMC)
Sobradillo, Patricia (Hospital Universitario de Cruces (Barakaldo, País Basc))
Lange, Peter (Copenhagen University)
Garcia-Aymerich, Judith (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Antó i Boqué, Josep Maria (Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública)
Turner, Alice M. (University of Birmingham)
Han, MeiLan K. (University of Michigan)
Langhammer, Arnulf (Nord-Trøndelag Hospital Trust)
Vikjord, Sigrid Anna Aalberg (Norwegian University of Science and Technology)
Sternberg, Alice (Johns Hopkins Bloomberg School of Public Health)
Leivseth, Linda (Northern Norway Regional Health Authority)
Bakke, Per (University of Bergen)
Johannessen, Ane (University of Bergen)
Oga, Toru (Kyoto University, Kyoto)
Cosio, Borja G.. (Institut d'Investigació Sanitària Illes Balears)
Echazarreta, Andrés L. (Servicio de Neumonología, Hospital San Juan de Dios de La Plata)
Roche, Nicolás (APHP Centre-University of Paris)
Burgel, Pierre-Regis (APHP Centre-University of Paris)
Sin, Don D. (University of British Columbia)
Puhan, Milo A. (University of Zurich)
López-Campos, José Luis (Instituto de Biomedicina de Sevilla)
Carrasco, Laura (Instituto de Biomedicina de Sevilla)
Soriano, Joan B.. (Centro de Investigación Biomédica en Red de Enfermedades Respiratorias)
Universitat Autònoma de Barcelona

Fecha:	2020
Resumen:	In 2019, The Global Initiative for Chronic Obstructive Lung Disease (GOLD) modified the grading system for patients with COPD, creating 16 subgroups (1A-4D). As part of the COPD Cohorts Collaborative International Assessment (3CIA) initiative, we aim to compare the mortality prediction of the 2015 and 2019 COPD GOLD staging systems. We studied 17 139 COPD patients from the 3CIA study, selecting those with complete data. Patients were classified by the 2015 and 2019 GOLD ABCD systems, and we compared the predictive ability for 5-year mortality of both classifications. In total, 17 139 patients with COPD were enrolled in 22 cohorts from 11 countries between 2003 and 2017; 8823 of them had complete data and were analysed. Mean± age was 63. 9±9. 8 years and 62. 9% were male. GOLD 2019 classified the patients in milder degrees of COPD. For both classifications, group D had higher mortality. 5-year mortality did not differ between groups B and C in GOLD 2015; in GOLD 2019, mortality was greater for group B than C. Patients classified as group A and B had better sensitivity and positive predictive value with the GOLD 2019 classification than GOLD 2015. GOLD 2015 had better sensitivity for group C and D than GOLD 2019. The area under the curve values for 5-year mortality were only 0. 67 (95% CI 0. 66-0. 68) for GOLD 2015 and 0. 65 (95% CI 0. 63-0. 66) for GOLD 2019. The new GOLD 2019 classification does not predict mortality better than the previous GOLD 2015 system. GOLD 2019 staging system created 16 subgroups. GOLD 2015 and GOLD 2019 are not strong predictors of mortality, and do not have sufficient discriminatory power to be used as a tool for risk classification of mortality in patients with COPD.
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	ERJ Open Research, Vol. 6 (november 2020) , ISSN 2312-0541

DOI: 10.1183/23120541.00253-2020
PMID: 33263033

10 p, 1.2 MB

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